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Cytoreductive Surgery with HIPEC

Advanced cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) at PristynCare. Expert treatment for peritoneal cancers with improved survival outcomes.

Advanced cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) at PristynCare. Expert treatment ... Read More

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    Dr. Kiran Dua - A gynaecologist for Endometriosis

    Dr. Kiran Dua

    MBBS, MD-Obs & Gynae
    48 Yrs.Exp.

    5.0/5

    48 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
    Call Us
    080-6542-3711
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    Dr. Krishan Kapur - A gynaecologist for Endometriosis

    Dr. Krishan Kapur

    MBBS, MD-Obs & Gynae
    42 Yrs.Exp.

    4.5/5

    42 Years Experience

    location icon Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi
    Call Us
    080-6962-5908
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    Dr. Uma Challa - A gynaecologist for Endometriosis

    Dr. Uma Challa

    MBBS, MD-Obs & Gynae
    42 Yrs.Exp.

    5.0/5

    42 Years Experience

    location icon 7-1-71/A/1, Dharam Karan Rd, ShivBagh, Ameerpet, Hyderabad, Telangana 500016
    Call Us
    080-6542-3712
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    Dr. Neeta Mishra - A gynaecologist for Endometriosis

    Dr. Neeta Mishra

    MBBS, MD-Obs & Gynae
    40 Yrs.Exp.

    5.0/5

    40 Years Experience

    location icon Pristyn Care Elantis, Ring Road, Lajpat Nagar
    Call Us
    080-6542-3711

Cytoreductive with HIPEC

Cytoreductive surgery (CRS) combined with HIPEC is a specialized treatment for peritoneal surface malignancies including peritoneal carcinomatosis from colorectal, ovarian, and appendiceal cancers. The procedure involves surgical removal of all visible tumor implants followed by heated chemotherapy to destroy residual cancer cells.

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Symptoms

Conditions treated with CRS-HIPEC present as:

  • Abdominal distension and ascites
  • Abdominal pain and bloating
  • Changes in bowel habits or obstruction
  • Unexplained weight loss and fatigue
  • Nausea, vomiting, and poor appetite
  • Palpable abdominal masses

Causes

CRS-HIPEC is indicated for peritoneal spread from:

  • Colorectal cancer peritoneal carcinomatosis
  • Ovarian cancer with peritoneal implants
  • Appendiceal cancer and pseudomyxoma peritonei
  • Gastric cancer peritoneal spread in selected cases
  • Mesothelioma of the peritoneum

Indications for CRS-HIPEC

Ideal candidates have:

  • Peritoneal carcinomatosis index (PCI) below 20
  • No or minimal systemic metastasis
  • Adequate performance status for major surgery
  • Responsive disease to prior chemotherapy
  • No extensive involvement of small bowel mesentery

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Risk Factors

Factors influencing outcome in CRS-HIPEC:

  • High peritoneal cancer index score
  • Prior multiple abdominal surgeries
  • Systemic metastases present
  • Poor nutritional status
  • Advanced age with low performance status

Who is at Risk

Patients with peritoneal carcinomatosis from colorectal, ovarian, or appendiceal cancers who have limited peritoneal disease and no systemic spread are candidates. A thorough multidisciplinary evaluation determines candidacy.

Diagnosis

Staging and workup includes:

  • CT scan with peritoneal staging protocol
  • PET scan for systemic disease evaluation
  • Diagnostic laparoscopy for peritoneal cancer index assessment
  • Tumor markers including CEA, CA125, and CA19-9
  • Core biopsy for histological confirmation
  • Multidisciplinary oncology review

Treatment Options

CRS-HIPEC involves complete tumor debulking followed by administration of heated intraperitoneal chemotherapy at 42 to 43 degrees Celsius for 90 minutes. Cisplatin, mitomycin-C, or oxaliplatin are commonly used agents depending on tumor type.

The Procedure

The CRS-HIPEC procedure involves:

  • Comprehensive pre-operative assessment and bowel preparation
  • Laparotomy with complete peritoneal exploration
  • Systematic peritonectomy and organ resection to achieve no visible residual disease
  • Bowel resection and anastomosis as required
  • HIPEC circuit with heated chemotherapy perfusion for 60 to 90 minutes
  • Abdominal closure with drain placement
  • ICU admission and close post-operative monitoring

After the Surgery

Post-operative care includes:

  • ICU stay for 24 to 48 hours post-procedure
  • Total hospital stay of 7 to 14 days
  • Nutritional support via parenteral or enteral feeding
  • Wound care and drain management
  • Regular blood test monitoring for chemotherapy effects
  • Follow-up CT scan at 3 months to assess response

Possible Complications of CRS-HIPEC

Potential complications include:

  • Anastomotic leak after bowel resection
  • Wound infection or abdominal abscess
  • Renal toxicity from intraperitoneal cisplatin
  • Bone marrow suppression from chemotherapy
  • Prolonged ileus and delayed gastric emptying
  • Pulmonary complications in prolonged surgery

Frequently Asked Questions

What is CRS-HIPEC surgery?

CRS-HIPEC combines surgical removal of all visible tumor implants from the peritoneum with heated intraperitoneal chemotherapy to treat peritoneal surface cancers.

Which cancers are treated with HIPEC?

HIPEC is used for colorectal, ovarian, appendiceal cancers with peritoneal spread, and peritoneal mesothelioma in carefully selected patients.

What is the recovery time after CRS-HIPEC?

Recovery takes 4 to 8 weeks. Hospital stay is typically 7 to 14 days, with gradual return to normal activities over the following weeks.

What are the survival benefits of CRS-HIPEC?

CRS-HIPEC has shown improved survival compared to systemic chemotherapy alone for peritoneal carcinomatosis in selected patients with complete cytoreduction.

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Medically Reviewed By
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Dr. Kiran Dua
MBBS, MD-Obs & Gynae
48 Years Experience Overall
Last Updated : April 29, 2026

What Our Patients Say

  • ME

    Mehak, 25 Yrs

    verified
    5/5

    My Endometriosis treatment was good and recovery seems great. Would like to thank dr radhikha G for it. She is really help full

    City : Chennai
    Treated by : Dr. Radhika G
  • HJ

    Hansika Jindal

    verified
    5/5

    One day, my friend Sneha told me she had been experiencing pain for two to three months, which was often much worse than normal period cramps. I suggested she consult a gynecologist and start treatment, and she is now well.

    City : Hyderabad
  • MI

    Meera Iyer

    verified
    5/5

    Endometriosis was ruining my daily life. The treatment suggested has given me so much relief. Can’t believe I can go through an entire month now without that unbearable pain.

    City : Hyderabad
  • NB

    Nisha Bhandari

    verified
    5/5

    Endometriosis treatment was handled very carefully. I used to think the pain was normal, but now I know it’s not. Life feels so much lighter.

    City : Hyderabad
  • SH

    Shalini, 27 Yrs

    verified
    5/5

    The best thing about she is an excellent and skilled surgeon she gave me a thorough explanation in a calm manner that i could understand, which nearly made the whole stressful situation enjoyable.

    City : Delhi
    Treated by : Dr. Nidhi Moda
  • PO

    Pooja, 38 Yrs

    verified
    5/5

    Recovery was smooth thanks to the doctor.

    City : Delhi
    Treated by : Dr. Kiran Dua